Gestational Diabetes

WHAT YOU SHOULD KNOW

Diabetes---the body's failure to convert sugar to energy---usually strikes people in their later years. However, some women are also liable to develop a temporary form of diabetes while carrying a baby. This type, which occurs in about 1 out of 25 pregnancies, has been labeled gestational diabetes. It occurs most frequently in the final 3 months before delivery. Like other forms of the disease, gestational diabetes is caused by either a shortage of the natural hormone insulin or the body's inability to use whatever insulin is available. When insulin fails to do its work, sugar builds up in the blood---and excess sugar can be very harmful to the baby. For this reason, it's essential to control your blood sugar level if you develop this disease. Although gestational diabetes usually goes away a few weeks after delivery, the problem may return later in life.

Causes

Hormones released by the placenta (the tissue in the uterus that connects mother and baby) tend to interfere with insulin. Gestational diabetes is more likely to result if you are overweight or over 30 years old, have had a previous stillborn delivery, or have a family history of diabetes. It's also more likely if the baby is unusually large (more than 9 pounds at birth).

Signs/Symptoms

• Hunger
• Thirst
• Frequent urination
• Blurred vision
• Excess weight gain during your pregnancy

WHAT YOU SHOULD DO

• If the diabetes is mild, you may be able to keep your blood sugar down by following a special diet recommended by your doctor.
• If the diabetes is serious enough, you may need to make regular checks of the sugar in your blood and give yourself insulin shots. You might be hospitalized for tests and treatment.
• Keep insulin, syringes, and a fast-acting sugar (such as hard candy) with you when away from home in case you have an attack of low or high blood sugar.

Call Your Doctor If...

• You think your baby is not moving as much as usual.

Seek Care Immediately If...

• If you have hypoglycemia (low blood sugar): Quickly drink one-half to 1 cup of fruit juice or non-diet cola, or quickly eat some hard candy, sugar pills, or sweet syrup, then call 911 for help. Signs of hypoglycemia are:
• Blurred or double vision
• Confusion
• Fainting
• Hunger
• Quick heart rate
• Quick, shallow breathing
• Shaking
• Sweating
• If you have hyperglycemia (high blood sugar): Take insulin based on your blood sugar level, then call your doctor immediately. If you cannot reach your doctor, have someone drive you to the nearest emergency room or call 911. Signs of hyperglycemia are:
• Abdominal pain
• Fast breathing
• "Fruity" smelling breath
• Headache
• Fast, weak pulse
• Nausea and vomiting
• Frequent urination
• Reddened, dry skin
• Sleepiness
• Thirst

IF YOU'RE HEADING FOR THE HOSPITAL...

What to Expect While You're There

You may encounter the following procedures and equipment during your stay.

• Taking Vital Signs: These include your temperature, blood pressure, pulse (counting your heartbeats), and respirations (counting your breaths). A stethoscope is used to listen to your heart and lungs. Your blood pressure is taken by wrapping a cuff around your arm.
• Fetal Heart Monitoring: A loose fitting belt may be placed around your abdomen to measure your baby's heart rate. The belt holds a small metal disc attached to a machine with a TV-like screen that shows a tracing of the baby's heartbeat.
• Urine Sample: A doctor may ask for a sample of your urine. It will be tested to determine the amount of ketones (KEE-tones) and sugar it contains. (When the body has excess sugar, some of it appears in the urine.) The results can alert the doctor to the need for more tests.
• Blood Tests: You'll probably have your blood sugar level tested. The blood can be drawn from a vein in your hand or from the bend in your elbow. Several samples may be needed.
• IV: A tube placed in your vein for giving medicine or liquids. The IV will be capped or have tubing connected to it.
• Strict Intake/Output: Your doctor may need to know the amount of liquid you are taking in versus the amount you lose in your urine. This is often called an "I&O."
• Unless told otherwise, drink 6 to 8 large glasses of water each day. Keep a record of exactly how much liquid you drink.
• Your output of urine may have to be measured. Ask your doctor whether it's OK to use the toilet.
• Ultrasound: This painless test uses sound waves to scan internal organs such as the uterus. Pictures of the organs show up on a TV-like screen.
• Insulin: If your blood sugar level is very high, you'll be given insulin to bring it under control. The insulin may be given as a shot many times a day or may be delivered through your IV. You'll later be taught how to give the insulin shots to yourself.